Gaze-initiated communications

ABSTRACT

A method comprises displaying an image of an environment on a graphical user interface, the environment including personnel elements visible in the image, detecting a gaze of a user directed at an image of a first personnel element corresponding to a first information conveyor of a plurality of information conveyors, changing a state of the first information conveyor corresponding to the first personnel element from a passive state to a listening state in response to detecting that the gaze is directed at the image of the first personnel element, wherein the first information conveyor includes a first audio output device, receiving audio information through an audio input device, and when the state of the first information conveyor is changed to the listening state, controlling an output operation, wherein the output operation includes directing the received audio information as an audio output through the first audio output device.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims the benefit of U.S. Provisional Application62/661,979 filed Apr. 24, 2018, which is incorporated by referenceherein in its entirety.

FIELD

The present disclosure is directed to managing medical systems and, moreparticularly, to systems and methods for initiating communications withmedical systems using gaze.

BACKGROUND

Minimally invasive medical techniques are intended to reduce the amountof extraneous tissue that is damaged during diagnostic or surgicalprocedures, thereby reducing patient recovery time, discomfort, andharmful side effects. Such minimally invasive techniques may beperformed through natural orifices in a patient anatomy or through oneor more surgical incisions. Through these natural orifices or incisions,clinicians may insert medical tools to reach a target tissue location.Minimally invasive medical tools include instruments such as therapeuticinstruments, diagnostic instruments, and surgical instruments. Minimallyinvasive medical tools may also include imaging instruments such asendoscopic instruments that provide a user with a field of view withinthe patient anatomy.

Some minimally invasive medical tools may be teleoperated, otherwiseremotely operated, or otherwise computer-assisted. A clinician may needto be able to communicate with a teleoperational system as well as othersystems in a surgical environment before, during, or after a medicalprocedure performed with the teleoperational system. Still further, aclinician may need to be able to easily communicate with other membersof the clinical team in a surgical environment before, during, or aftera medical procedure. Systems and methods for improving the process bywhich medical personnel communicate with each other and with systems ina surgical environment are needed.

SUMMARY

The embodiments of the invention are summarized by the claims thatfollow the description.

In one embodiment, a method is provided for gaze-initiatedcommunications. A gaze of a user is detected being directed at anelement in a graphical user interface. The graphical user interface isdisplayed on a display system located in an environment. A state of theelement is changed in response to detecting that the gaze is directed atthe element. Audio information is received through an audio inputdevice. An output operation is controlled based on the state of theelement such that the audio information received through the audio inputdevice is directed to an information conveyor corresponding to theelement.

In another embodiment, a method for selectively communicating audioinformation using gaze is provided. A gaze of a user is detected beingdirected at an element in a graphical user interface. The graphical userinterface is displayed on a display system located in an environment andwherein the element is associated with at least one communicationchannel. A state of the element is changed to a listening state inresponse to detecting that the gaze is directed at the element. A visualcue is presented in the graphical user interface indicating that theelement is now in the listening state. Audio information is receivedthrough an audio input device. The audio information received throughthe audio input device is directed to the at least one communicationchannel associated with the element while the element is in thelistening state.

In yet another embodiment, a method for selectively controlling aplurality of systems using voice commands is provided. A gaze of a useris detected being directed at an element in a graphical user interface.The graphical user interface is displayed on a display system located inan environment and wherein the element represents a system. Audioinformation is received through an audio input device. The audio inputdevice is directed to an information conveyor dedicated to receivingvoice commands for the system represented by the element. Speechrecognition context information designated for the system represented bythe element is selected for use in processing the audio information. Theaudio information is processed using the speech recognition contextinformation to generate output information that is used to control anoperation of the system represented by the element.

In another embodiment, an apparatus comprises a display system, a gazetracking system, an audio input device, and a processor. The displaysystem is located in an environment and configured to display agraphical user interface that includes a plurality of elements. The gazetracking system is configured to detect a gaze of a user that isdirected at an element of the plurality of elements in the graphicaluser interface. The audio input device is configured to receive audioinformation. The processor is configured to change a state of theelement in response to detecting that the gaze is directed at theelement and to control an output operation based on the state of theelement such that the audio information received through the audio inputdevice is directed to an information conveyor corresponding to theelement.

It is to be understood that both the foregoing general description andthe following detailed description are exemplary and explanatory innature and are intended to provide an understanding of the presentdisclosure without limiting the scope of the present disclosure. In thatregard, additional aspects, features, and advantages of the presentdisclosure will be apparent to one skilled in the art from the followingdetailed description.

BRIEF DESCRIPTIONS OF THE DRAWINGS

Aspects of the present disclosure are best understood from the followingdetailed description when read with the accompanying figures. It isemphasized that, in accordance with the standard practice in theindustry, various features are not drawn to scale. In fact, thedimensions of the various features may be arbitrarily increased orreduced for clarity of discussion. In addition, the present disclosuremay repeat reference numerals and/or letters in the various examples.This repetition is for the purpose of simplicity and clarity and doesnot in itself dictate a relationship between the various embodimentsand/or configurations discussed.

FIG. 1A is a schematic view of a medical system, in accordance with anembodiment.

FIG. 1B is a perspective view of an assembly, in accordance with anembodiment.

FIG. 1C is a perspective view of a surgeon's control console for amedical system, in accordance with an embodiment.

FIG. 2 is a schematic diagram of an environment in which a user may usegaze to control speech-based communications, in accordance with anembodiment.

FIG. 3 is an illustration of an example embodiment of the graphical userinterface from FIG. 2 , in accordance with an embodiment.

FIG. 4 is a flowchart illustration of a method for performing gaze-basedcommunications, in accordance with an embodiment.

FIG. 5 is a flowchart illustration of a method for selectivelycontrolling communications over audio communication channels based ongaze, in accordance with an embodiment.

FIG. 6 is a flowchart illustration of a method for selectivelycontrolling the operation of systems based on gaze, in accordance withan embodiment.

FIG. 7 is a flowchart illustration of a method for processing voicecommands after an element has been set to a listening state, inaccordance with an embodiment.

FIG. 8 is a flowchart illustration of a method for conveying audioinformation to a particular information conveyor assigned to aparticular headset, in accordance with an embodiment.

DETAILED DESCRIPTION

For the purposes of promoting an understanding of the principles of thepresent disclosure, reference will now be made to the embodimentsillustrated in the drawings, and specific language will be used todescribe the same. It will nevertheless be understood that no limitationof the scope of the disclosure is intended. In the following detaileddescription of the aspects of the invention, numerous specific detailsare set forth in order to provide a thorough understanding of thedisclosed embodiments. However, as would be appreciated by one skilledin the art, embodiments of this disclosure may be practiced withoutthese specific details. In other instances well known methods,procedures, components, and circuits have not been described in detailso as not to unnecessarily obscure aspects of the embodiments of theinvention.

Any alterations and further modifications to the described devices,instruments, methods, and any further application of the principles ofthe present disclosure are fully contemplated as would normally occur toone skilled in the art to which the disclosure relates. In particular,it is fully contemplated that the features, components, and/or stepsdescribed with respect to one embodiment may be combined with thefeatures, components, and/or steps described with respect to otherembodiments of the present disclosure. In addition, dimensions providedherein are for specific examples and it is contemplated that differentsizes, dimensions, and/or ratios may be utilized to implement theconcepts of the present disclosure. To avoid needless descriptiverepetition, one or more components or actions described in accordancewith one illustrative embodiment may be used or omitted as applicablefrom other illustrative embodiments. For the sake of brevity, thenumerous iterations of these combinations will not be describedseparately. For simplicity, in some instances the same reference numbersare used throughout the drawings to refer to the same or like parts.

The embodiments below will describe various instruments and portions ofinstruments in terms of their state in three-dimensional space. As usedherein, the term “position” refers to the location of an object or aportion of an object in a three-dimensional space (e.g., three degreesof translational freedom along Cartesian X, Y, Z coordinates). As usedherein, the term “orientation” refers to the rotational placement of anobject or a portion of an object (three degrees of rotationalfreedom—e.g., roll, pitch, and yaw). As used herein, the term “pose”refers to the position of an object or a portion of an object in atleast one degree of translational freedom and to the orientation of thatobject or portion of the object in at least one degree of rotationalfreedom (up to six total degrees of freedom).

Referring now to the drawings, FIGS. 1A, 1B, and 1C together provide aschematic overview of a medical system 10 that may be used in, forexample, medical procedures including diagnostic, therapeutic, orsurgical procedures. The medical system 10 is located in a surgicalenvironment 11. In one or more embodiments, the medical system 10 may bea teleoperational medical system that is under the teleoperationalcontrol of a surgeon. In alternative embodiments, the medical system 10may be under the partial control of a computer programmed to perform themedical procedure or sub-procedure. In still other alternativeembodiments, the medical system 10 may be a fully automated medicalsystem that is under the full control of a computer programmed toperform the medical procedure or sub-procedure with the medical system10. One example of the medical system 10 that may be used to implementthe systems and techniques described in this disclosure is the da Vinci®Surgical System manufactured by Intuitive Surgical, Inc. of Sunnyvale,Calif.

As shown in FIG. 1A, the medical system 10 generally includes anassembly 12, which may be mounted to or positioned near an operatingtable O on which a patient P is positioned. The assembly 12 may bereferred to as a patient side cart, a surgical cart, or a surgicalrobot. In one or more embodiments, the assembly 12 may be ateleoperational assembly. The teleoperational assembly may be referredto as, for example, a teleoperational arm cart. A medical instrumentsystem 14 and an endoscopic imaging system 15 are operably coupled tothe assembly 12. An operator input system 16 allows a surgeon or othertype of clinician S to view images of or representing the surgical siteand to control the operation of the medical instrument system 14 and/orthe endoscopic imaging system 15.

The medical instrument system 14 may comprise one or more medicalinstruments. In embodiments in which the medical instrument system 14comprises a plurality of medical instruments, the plurality of medicalinstruments may include multiple of the same medical instrument and/ormultiple different medical instruments. Similarly, the endoscopicimaging system 15 may comprise one or more endoscopes. In the case of aplurality of endoscopes, the plurality of endoscopes may includemultiple of the same endoscope and/or multiple different endoscopes.

The operator input system 16 may be located at a surgeon's controlconsole 17 and may be located in the same room as operating table O. Insome embodiments, the surgeon S and the operator input system 16 may belocated in a different room or a completely different building from thepatient P. The operator input system 16 generally includes one or morecontrol device(s) for controlling the medical instrument system 14. Thecontrol device(s) may include one or more of any number of a variety ofinput devices, such as hand grips, joysticks, trackballs, data gloves,trigger-guns, foot pedals, hand-operated controllers, voice recognitiondevices, touch screens, body motion or presence sensors, and other typesof input devices.

In some embodiments, the control device(s) will be provided with thesame degrees of freedom as the medical instrument(s) of the medicalinstrument system 14 to provide the surgeon with telepresence, which isthe perception that the control device(s) are integral with theinstruments so that the surgeon has a strong sense of directlycontrolling instruments as if present at the surgical site. In otherembodiments, the control device(s) may have more or fewer degrees offreedom than the associated medical instruments and still provide thesurgeon with telepresence. In some embodiments, the control device(s)are manual input devices that move with six degrees of freedom, andwhich may also include an actuatable handle for actuating instruments(for example, for closing grasping jaw end effectors, applying anelectrical potential to an electrode, delivering a medicinal treatment,and actuating other types of instruments).

The assembly 12 supports and manipulates the medical instrument system14 while the surgeon S views the surgical site through the operatorinput system 16. An image of the surgical site may be obtained by theendoscopic imaging system 15, which may be manipulated by the assembly12. The assembly 12 may comprise endoscopic imaging systems 15 and maysimilarly comprise multiple medical instrument systems 14 as well. Thenumber of medical instrument systems 14 used at one time will generallydepend on the diagnostic or surgical procedure to be performed and onspace constraints within the operating room, among other factors. Theassembly 12 may include a kinematic structure of one or more non-servocontrolled links (e.g., one or more links that may be manuallypositioned and locked in place, generally referred to as a set-upstructure) and a manipulator. When the manipulator takes the form of ateleoperational manipulator, the assembly 12 is a teleoperationalassembly. The assembly 12 includes a plurality of motors that driveinputs on the medical instrument system 14. In an embodiment, thesemotors move in response to commands from a control system (e.g., controlsystem 20). The motors include drive systems which when coupled to themedical instrument system 14 may advance a medical instrument into anaturally or surgically created anatomical orifice. Other motorizeddrive systems may move the distal end of said medical instrument inmultiple degrees of freedom, which may include three degrees of linearmotion (e.g., linear motion along the X, Y, Z Cartesian axes) and threedegrees of rotational motion (e.g., rotation about the X, Y, Z Cartesianaxes). Additionally, the motors may be used to actuate an articulableend effector of the medical instrument for grasping tissue in the jawsof a biopsy device or the like. Medical instruments of the medicalinstrument system 14 may include end effectors having a single workingmember such as a scalpel, a blunt blade, an optical fiber, or anelectrode. Other end effectors may include, for example, forceps,graspers, scissors, or clip appliers.

The medical system 10 also includes a control system 20. The controlsystem 20 includes at least one memory 24 and at least one processor 22for effecting control between the medical instrument system 14, theoperator input system 16, and other auxiliary systems 26 which mayinclude, for example, imaging systems, audio systems, fluid deliverysystems, display systems, illumination systems, steering controlsystems, irrigation systems, and/or suction systems. A clinician C maycirculate within the surgical environment 11 and may access, forexample, the assembly 12 during a set up procedure or view a display ofthe auxiliary system 26 from the patient bedside.

Though depicted as being external to the assembly 12 in FIG. 1A, thecontrol system 20 may, in some embodiments, be contained wholly withinthe assembly 12. The control system 20 also includes programmedinstructions (e.g., stored on a non-transitory, computer-readablemedium) to implement some or all of the methods described in accordancewith aspects disclosed herein. While the control system 20 is shown as asingle block in the simplified schematic of FIG. 1A, the control system20 may include two or more data processing circuits with one portion ofthe processing optionally being performed on or adjacent the assembly12, another portion of the processing being performed at the operatorinput system 16, and the like.

Any of a wide variety of centralized or distributed data processingarchitectures may be employed. Similarly, the programmed instructionsmay be implemented as a number of separate programs or subroutines, orthey may be integrated into a number of other aspects of the systemsdescribed herein, including teleoperational systems. In one embodiment,the control system 20 supports wireless communication protocols such asBluetooth, IrDA, HomeRF, IEEE 802.11, DECT, and Wireless Telemetry.

The control system 20 is in communication with a database 27 which maystore one or more clinician profiles, a list of patients and patientprofiles, a list of procedures to be performed on said patients, a listof clinicians scheduled to perform said procedures, other information,or combinations thereof. A clinician profile may comprise informationabout a clinician, including how long the clinician has worked in themedical field, the level of education attained by the clinician, thelevel of experience the clinician has with the medical system 10 (orsimilar systems), or any combination thereof.

The database 27 may be stored in the memory 24 and may be dynamicallyupdated. Additionally or alternatively, the database 27 may be stored ona device such as a server or a portable storage device that isaccessible by the control system 20 via an internal network (e.g., asecured network of a medical facility or a teleoperational systemprovider) or an external network (e.g. the Internet). The database 27may be distributed throughout two or more locations. For example, thedatabase 27 may be present on multiple devices which may include thedevices of different entities and/or a cloud server. Additionally oralternatively, the database 27 may be stored on a portable user-assigneddevice such as a computer, a mobile device, a smart phone, a laptop, anelectronic badge, a tablet, a pager, and other similar user devices.

In some embodiments, control system 20 may include one or more servocontrollers that receive force and/or torque feedback from the medicalinstrument system 14. Responsive to the feedback, the servo controllerstransmit signals to the operator input system 16. The servocontroller(s) may also transmit signals instructing assembly 12 to movethe medical instrument system(s) 14 and/or endoscopic imaging system 15which extend into an internal surgical site within the patient body viaopenings in the body. Any suitable conventional or specialized servocontroller may be used. A servo controller may be separate from, orintegrated with, assembly 12. In some embodiments, the servo controllerand assembly 12 are provided as part of a teleoperational arm cartpositioned adjacent to the patient's body.

The control system 20 can be coupled with the endoscopic imaging system15 and can include a processor to process captured images for subsequentdisplay, such as to a surgeon on the surgeon's control console 17, or onanother suitable display located locally and/or remotely. For example,where a stereoscopic endoscope is used, the control system 20 canprocess the captured images to present the surgeon with coordinatedstereo images of the surgical site. Such coordination can includealignment between the opposing images and can include adjusting thestereo working distance of the stereoscopic endoscope.

In alternative embodiments, the medical system 10 may include more thanone assembly 12 and/or more than one operator input system 16. The exactnumber of assemblies 12 will depend on the surgical procedure and thespace constraints within the operating room, among other factors. Theoperator input systems 16 may be collocated or they may be positioned inseparate locations. Multiple operator input systems 16 allow more thanone operator to control one or more assemblies 12 in variouscombinations.

The medical system 10 may also be used to train and rehearse medicalprocedures. For example, the medical system 10 may be used inconjunction with the gaze-based control system described below in FIG. 2to allow the surgeon S to communicate with other personnel in thesurgical environment 11 based on the gaze of the surgeon S and tocontrol one or more systems based on the gaze of the surgeon S.

FIG. 1B is a perspective view of one embodiment of an assembly 12 whichmay be referred to as a patient side cart, surgical cart,teleoperational arm cart, or surgical robot. The assembly 12 shownprovides for the manipulation of three surgical tools 30 a, 30 b, 30 c(e.g., medical instrument systems 14) and an imaging device 28 (e.g.,endoscopic imaging system 15), such as a stereoscopic endoscope used forthe capture of images of the site of the procedure. The imaging devicemay transmit signals over a cable 56 to the control system 20.Manipulation is provided by teleoperative mechanisms having a number ofjoints. The imaging device 28 and the surgical tools 30 a-c can bepositioned and manipulated through incisions in the patient so that akinematic remote center is maintained at the incision to minimize thesize of the incision. Images of the surgical site can include images ofthe distal ends of the surgical tools 30 a-c when they are positionedwithin the field-of-view of the imaging device 28.

The assembly 12 includes a drivable base 58. The drivable base 58 isconnected to a telescoping column 57, which allows for adjustment of theheight of arms 54. The arms 54 may include a rotating joint 55 that bothrotates and moves up and down. Each of the arms 54 may be connected toan orienting platform 53. The arms 54 may be labeled to facilitatetrouble shooting. For example, each of the arms 54 may be emblazonedwith a different number, letter, symbol, other identifier, orcombinations thereof. The orienting platform 53 may be capable of 360degrees of rotation. The assembly 12 may also include a telescopinghorizontal cantilever 52 for moving the orienting platform 53 in ahorizontal direction.

In the present example, each of the arms 54 connects to a manipulatorarm 51. The manipulator arms 51 may connect directly to a medicalinstrument, e.g., one of the surgical tools 30 a-c. The manipulator arms51 may be teleoperatable. In some examples, the arms 54 connecting tothe orienting platform 53 may not be teleoperatable. Rather, such arms54 may be positioned as desired before the surgeon S begins operationwith the teleoperative components. Throughout a surgical procedure,medical instruments may be removed and replaced with other instrumentssuch that instrument to arm associations may change during theprocedure.

Endoscopic imaging systems (e.g., endoscopic imaging system 15 andimaging device 28) may be provided in a variety of configurationsincluding rigid or flexible endoscopes. Rigid endoscopes include a rigidtube housing a relay lens system for transmitting an image from a distalend to a proximal end of the endoscope. Flexible endoscopes transmitimages using one or more flexible optical fibers. Digital image basedendoscopes have a “chip on the tip” design in which a distal digitalsensor such as a one or more charge-coupled device (CCD) or acomplementary metal oxide semiconductor (CMOS) device store image data.Endoscopic imaging systems may provide two- or three-dimensional imagesto the viewer. Two-dimensional images may provide limited depthperception. Three-dimensional stereo endoscopic images may provide theviewer with more accurate depth perception. Stereo endoscopicinstruments employ stereo cameras to capture stereo images of thepatient anatomy. An endoscopic instrument may be a fully sterilizableassembly with the endoscope cable, handle and shaft all rigidly coupledand hermetically sealed.

FIG. 1C is a perspective view of an embodiment of the operator inputsystem 16 at a surgeon's control console 17. The operator input system16 includes a left eye display 32 and a right eye display 34 forpresenting the surgeon S with a coordinated stereo view of the surgicalenvironment that enables depth perception. The operator input system 16further includes one or more input control devices 36, which in turncause the assembly 12 to manipulate one or more instruments of theendoscopic imaging system 15 and/or medical instrument system 14. Theinput control devices 36 can provide the same degrees of freedom astheir associated instruments to provide the surgeon S with telepresence,or the perception that the input control devices 36 are integral withsaid instruments so that the surgeon has a strong sense of directlycontrolling the instruments. To this end, position, force, and tactilefeedback sensors (not shown) may be employed to transmit position,force, and tactile sensations from the medical instruments, e.g.,surgical tools 30 a-c, or imaging device 28, back to the surgeon's handsthrough the input control devices 36. Input control devices 37 are footpedals that receive input from a user's foot. Aspects of the operatorinput system 16, the assembly 12, and the auxiliary systems 26 may beadjustable and customizable to meet the physical needs, skill level, orpreferences of the surgeon S. Operator input system 16 may furtherinclude or be associated with a gaze tracking system 40 to determine agaze point of an operator (e.g. surgeon S) with respect to a display onthe left and right eye displays 32, 34. Examples of devices and methodsthat may be used to implement the gaze tracking system 230 are describedin further detail in U.S. patent Ser. No. 15/126,074, entitled “MedicalDevices, Systems, and Methods Using Eye Gaze Tracking,” which ishereinafter incorporated by reference in its entirety.

FIG. 2 is a schematic diagram of an environment 200 in which a user 203may use gaze to control speech-based communications. In one embodiment,the environment 200 is a medical environment, such as an operating room(e.g. the surgical environment 11 of FIG. 1A). In other embodiments, theenvironment 200 may be an emergency room, a surgical trainingenvironment, a medical laboratory, or some other type of environment inwhich any number of medical procedures or medical training proceduresmay take place. In some embodiments, the user 203 may be, for example,the surgeon S described in FIG. 1A. In other embodiments, the user 203may be some other medical professional or medical operator.

The environment 200 includes a display system 204, a control system 206(e.g., the control system 20), an audio input device 214, and a gazetracking system 208 (e.g., the gaze tracking system 40). In one or moreembodiments, the control system 206 is communicatively coupled to thedisplay system 204 and to the gaze tracking system 208. Components maycommunicate with the control system through one or more wired, wireless,optical, and/or other types of communications links. In someembodiments, the gaze tracking system 208 may also be communicativelycoupled to the display system 204. In one embodiment, the gaze trackingsystem 208 is physically coupled to the display system 204. In otherembodiments, the gaze tracking system 208 may be integrated as part ofthe display system 204. In still other embodiments, the control system206 is implemented as part of the display system 204.

The control system 206 may include one or more processors capable ofrunning executable code stored on at least one memory. As one example,the control system 206 may be used to run executable code stored onmemory to process information received from the gaze tracking system208.

The display system 204 may include one or more display devices (e.g.monitors, headsets, touchscreens, etc.). In one embodiment, the displaysystem 204 may be implemented as or as part of the surgeon's controlconsole 17 of FIG. 1C (e.g., left and right eye displays 32, 34). Thedisplay system 204 visually presents at least one display to the user203 that features a graphical user interface 210. The graphical userinterface 210 includes a plurality of graphical elements 219 that may becontrolled by a gaze input as described in detail below.

The audio input device 214 may include at least one microphone. Forexample, the audio input device 214 may be incorporated into thesurgeon's console 17 or a headset or may be otherwise located near theuser 203 in the environment 200 to allow voice communication from theuser 203 to be detected and captured.

In another example embodiment, the audio input device 214 is an intercomsystem located within the environment 200. The intercom system may alsobe referred to as a multi-channel intercom system. In some embodiments,the control system 206 may be considered part of the audio input device214. In other embodiments, one or more of the processors that make thecontrol system 206 may be considered part of the audio input device 214.

The control system 206 may process audio information received from theaudio input device 214 and selectively communicate the audio informationto personnel members 215 and/or systems 216 using one or moreinformation conveyors 212 associated with respective personnel members215 and/or systems 216. The systems 216 may be, for example, componentsystems of the medical system 10. The personnel members 215 and systems216 may be located in the environment 200 and/or may be located outsidethe environment.

The information conveyors 212 may include any number of communicationchannels, audio output devices or systems, or combination thereof forcarrying, communicating, or otherwise conveying the audio information. Acommunication channel may include, for example, a wirelesscommunications link, a wired communications link, a digitalcommunication channel, an analog communication channel, an audio cable,some other type of transmission medium or logical connection, or acombination thereof. An audio output device or system may include, forexample, an electroacoustic transducer (e.g. a speaker, a headset, anearbud(s), a headphone, etc.). In some embodiments, an informationconveyor 212 corresponding to a system 216 may include at least one of awire, an optical fiber, a wireless communication channel, storage media,a computer bus, or some other type of communication channel. In one ormore embodiments, a communication channel or audio output device orsystem may be part of one of the systems 216.

The gaze tracking system 208 includes a device that tracks the eyemovement (i.e. gaze) of the user 203 with respect to the graphical userinterface 210 to generate gaze information that is sent to the controlsystem 206 for processing. In some embodiments, the gaze tracking system208 may also be referred to as an eye tracking device or eye trackingsystem. The gaze tracking system 208 is used to determine the directionof and/or location of the gaze of the user 203 relative to the graphicaluser interface 210. For example, the gaze tracking system 208 may beable to detect when the gaze of the user 203 is directed at an element219 of the graphical user interface 210.

The graphical user interface 210 presents the elements 219 to the user203 to allow the user 203 to selectively communicate with the personnelmembers 215 and/or the systems 216 through one or more informationconveyors 212 based on gaze. The elements 219 may include, for example,graphical icons, display sections, windows, images, text, buttons, othertypes of graphical features, or a combination thereof. In someembodiments, the elements 219 may be referred to as user interfaceelements.

In one or more embodiments, the elements 219 include a viewing area 220,personnel elements 222, and system elements 224. The viewing area 220may include an image(s) or a sequence of images obtained from an imagingsystem (e.g. the endoscopic imaging system 15 of FIG. 1A). In oneembodiment, the viewing area 220 visually presents the image(s) orsequence of images to the user 203 in real-time or near real-time as amedical procedure is being performed within the environment 200.Further, the personnel elements 222 of the graphical user interface 210may visually present to the user 203 icons that represent the personnelmembers 215 and their respective information conveyors 212. The systemelements 224 of the graphical user interface 210 may visually present tothe user 203 icons that represents the systems 216 and their respectiveinformation conveyors 212.

In some embodiments, the information conveyors 212 include audiocommunication channels corresponding to the personnel members 215. Forexample, the information conveyors 212 may include an audiocommunication channel for communicating audio information to each of thepersonnel members 215. In one embodiment, the information conveyors 212may include an audio communication channel for communicating audioinformation to a team of personnel members 215. Thus, the personnelelements 222 allow the user 203 to selectively interact with thepersonnel members 215 over their respective information conveyors 212,which may be audio communication channels, based on the gaze of the user203.

In particular, each personnel element 222 may identify or be associatedwith one or more personnel members 215 with whom the user 203 may desireor expect to communicate when the user 203 is in the environment 200.The one or more personnel members 215 may be located inside theenvironment 200, outside the environment 200, or both. The personnelelement 222 may identify a particular person by a name, a medicalprofession, a medical role, a team name, a team type, a category ofpersonnel, or some other classification for personnel. For example, thepersonnel element 222 may be the identification of a physician, acirculator, a first assist nurse, a scrub nurse, a sterile team, anon-sterile team, a predetermined medical team, an entire team, atechnician, some other type of operator, or a combination thereof. Aninformation conveyor 212 may include audio speakers located near a knownor tracked location of the personnel member. For example, the audiospeakers may be located in a headset worn by the personnel member or ata work console of the personnel member.

In some embodiments, the system elements 224 may also allow the user 203to selectively interact with or control the systems 216 based on thegaze of the user 203. Each system element 224 may identify or beassociated with one or more systems 216 to which or about which the user203 may desire or expect to communicate when the user 203 is in theenvironment 200. The systems 216 may include various systems locatedinside the environment 200, outside the environment 200, or both. Asystem 216 may be, for example, without limitation, a speaker, a lightdevice, a note-taking application, a database, a robotic device, amedical imaging device, an imaging mode, a medical system, some othertype of system or group of systems, or a combination thereof.

The gaze of the user 203 may be directed at any one of the elements 219to selectively control the use of and determine the recipient of audioinformation received by the audio input device 214. More specifically,gaze information generated by the gaze tracking system 208 may beprocessed by the control system 206 and used to control where the speechof the user 203 is focused or directed or how the speech of the user 203is used to control other systems, such as the systems 216. Based on thegaze information, the control system 206 may change a state of theelement 219 at which the gaze of the user 203 is directed. For example,each of the elements 219 may be switched between a listening state and apassive (not listening) state. The control system 206 may direct theaudio information received at the audio input device 214 to the systems216 and personnel members 215 based on the listening and passive states.The processes used to change the state of the elements 219 and controlthe processing of the audio information based on the gaze of the user203 are described in greater detail below in FIGS. 4-6 .

FIG. 3 is an illustration of an example embodiment of the graphical userinterface 210 described in FIG. 2 . As depicted, the graphical userinterface 210 includes the viewing area 220, the personnel elements 222,and the system elements 224.

In this example embodiment, the viewing area 220 presents an image 300to the user 203. The image 300 is an example of one element of theplurality of elements 219 described in FIG. 2 . In one embodiment, theimage 300 may be obtained from, for example, the endoscopic imagingsystem 15 of FIG. 1A. In particular, the image 300 may be asubstantially real-time image of a surgical procedure being performed bythe user 203 using, for example, surgical tool 30 a and surgical tool 30b of FIG. 1B.

In one embodiment, the image 300 presented in the viewing area 220 isassigned to a default listening (e.g. activated) state for the audioinput device 214 of FIG. 2 such that when a gaze of the user 203 isdetected in a direction of the image 300, a state of the viewing area220 is changed to a listening state, which thereby results in the audioinput device 214 being set to the default listening state. For example,the audio input device 214 may be part of a multi-channel intercomsystem that includes the information conveyors 212 in the form of audiocommunication channels. In the default listening state, the audio inputdevice 214 and the control system 206 may be configured such that audioinput, such as the speech of user 203, is communicated across each audiocommunication channel. In other words, communications (i.e. thetransmission of audio information) may be broadcast over all channels ofthe multi-channel intercom system. In some embodiments, the viewing area220 may be set to a default listening state such that the viewing area220 is in the default listening state, even when a gaze is not detectedat the viewing area 220, until a gaze is directed at another element ofthe plurality of elements 219.

The personnel elements 222 include icons 306, 308, 310, 312, 314, and316, each of which represents a different personnel member(s) 215 and isassociated with a different respective information conveyor of theinformation conveyors 212 described in FIG. 2 for communicating audioinformation to the personnel member(s) 215. For example, the icons 306,308, 310, 312, 314, and 316 represent various audio communicationchannels for communicating with a circulator, a first assist nurse, ascrub nurse, an entire team, a sterile team, and a non-sterile team,respectively.

The system elements 224 include icons 318, 320, 322, 324, and 326, eachof which represents a different system(s) 216 and is associated with adifferent respective information conveyor of the information conveyors212 for communicating audio information to the system(s) 216. Forexample, the icons 318, 320, 322, 324, and 326 represent componentsystems of the medical system 10 in FIG. 1A, including the medicalsystem 10, an endoluminal light device, an endoluminal fluorescentdevice, a speaker device, and a note-taking application, respectively.In some embodiments, each of the icons 318, 320, 322, 324, and 326 maybe associated with a same information conveyor 212 in the form of acommunication channel, wired or wireless communications link, storagemedia, or computer bus specifically dedicated to receiving voicecommands for the systems 216 represented by these icons.

In one or more embodiments, a graphical feature 328 may be displayed inassociation with any of the icons 306-326 to present additionalinformation to the user 203 about the listening or passive state of anelement and the respective information conveyor 212. For example, thegraphical feature 328 may be used to indicate when the particular one ofthe icons 306-326 is set to a listening state. A listening state for aparticular icon indicates that audio information received at the audioinput device 214 will be communicated through the information conveyor212 associated with the particular icon to the personnel member(s)and/or system(s) represented by the particular icon. In other words, thelistening state for a particular icon indicates that the informationconveyor 212 associated with the particular icon will be “listening” foraudio (e.g. speech) input.

In this example embodiment, the graphical feature 328 is displayed inassociation with the icon 318. The graphical feature 328 is a visual cueindicating to the user 203 that any speech of the user 203 will bedirected at the medical system 10 of FIG. 1A represented by the icon318. In various embodiments, multiple graphical features 328 may appearin the graphical user interface 210. For example, if the user 203 gazesat the icons 306 and 308, the graphical features may appear next toicons 306 and 308, indicating that audio information received at theaudio input device 214 will be directed to the information conveyors 212associated with personnel members Circulator Nurse Jones and FirstAssistant Nurse Smith. The graphical feature 328, which may also bereferred to as a graphical cue, may be a graphical depiction of a set ofheadphones as shown. Alternatively, the graphical feature 328 may beanother symbol, a color change of the element, an outline of theelement, or any other visual cue to distinguish listening, orgaze-selected, elements from passive, or unselected, elements.

In some example embodiments, textual cues may be displayed inassociation with an icon. These textual cues may indicate to the user203 the particular voice commands that may be used to control theparticular system represented by a corresponding icon. For example, thetextual cue “ON” and the textual cue “OFF” may be displayed over or nearthe icon 322. These textual cues may indicate to the user 203 that thevoice commands of “ON” or “OFF” can be used to control the systemrepresented by the icon 322. As another example, the textual cues“BRIGHTER” and “DIMMER” may be displayed over or near the icon 320 toindicate the voice commands that can be used to control the systemrepresented by the icon 320. In this manner, textual cues may be used to“seed” the user 203 with verbiage for the voice commands that aresupported by speech recognition and that may be used to controldifferent systems. Further, the textual cues may also provide amechanism to improve the usability and reliability of speech recognitionby suggesting terms or phrases that are optimized based on variouscriteria. For example, the textual cues may be selected such that theyare short, phonetically distinct, easy to enunciate, easy to remember,optimized in some other manner, or a combination thereof.

FIG. 4 is a flowchart illustration of a method 400 for performinggaze-based communications. In one or more embodiments, the gaze-basedcommunications are to be performed in the environment 200 of FIG. 2(e.g. the surgical environment 11 of FIG. 1A). The method 400 isillustrated in FIG. 4 as a set of operations or processes 402 through408 and is described with continuing reference to FIGS. 2-3 . Not all ofthe illustrated processes 402 through 408 may be performed in allembodiments of method 400. Additionally, one or more processes that arenot expressly illustrated in FIG. 4 may be included before, after, inbetween, or as part of the processes 402 through 408. In someembodiments, one or more of the processes 402 through 408 may beimplemented, at least in part, in the form of executable code stored onnon-transitory, tangible, machine-readable media that when run by one ormore processors (e.g., the processors of control system) may cause theone or more processors to perform one or more of the processes.

At process 402, a gaze of the user 203 is detected being directed at anelement 219 in the graphical user interface 210. At process 404, a stateof the element 219 is changed in response to detecting that the gaze isdirected at the element 219. For example, the element 219 may beswitched from a passive state (or not listening state) to a listeningstate.

When the element 219 represents one or more personnel members 215, thelistening state indicates that speech received through the audio inputdevice 214 will be directed to at least one corresponding informationconveyor 212 associated with the element 219 and that enables the speechto be communicated to the one or more personnel members 215. When theelement 219 represents one or more systems 216, the listening stateindicates that speech received through the audio input device 214 willbe directed to at least one corresponding information conveyor 212associated with the element 219 dedicated to receiving voice commandsfor the one or more systems 216. The speech (e.g. voice commands) maythen be processed using speech recognition context informationdesignated for that system to generate output information that may thenbe used to control the operation of the one or more systems 216. In someembodiments, activating the state of any element may include activatingthe audio input device 214.

At process 406, audio information is then received through the audioinput device 214. At process 408, an output operation of the controlsystem 206 is controlled based on the state of the element 219 such thataudio information received through the audio input device 214 isdirected to at least one information conveyor 212 associated with theelement 219. The audio information may include, for example, withoutlimitation, a voice command, audio instructions, an audio report, audiocommentary related to a surgical procedure, some other type of verbalcommunication, or a combination thereof. In some embodiments, the audioinformation may be the oral dictation of a surgical case note by theuser 203, which, in some cases, may be recorded by the audio inputdevice 214 at process 406.

With respect to process 408, the control system 206 may control theoutput operation in different ways. For example, based on the state ofthe viewing area 220, the control system 206 may control whether or notthe audio input device 214 is in a passive state. More specifically, thecontrol system 206 may control whether the audio input device 214 islistening or not listening (passive). In another example, based on thestate of the personnel element 222 representing a selected personnelmember 215, the control system 206 controls the output operation todetermine whether to direct an audio output signal to an informationconveyor 212 in the form of a communication channel associated with theselected personnel member 215. If the state of the personnel element 222is listening, the audio output signal is transmitted via thecommunication channel. If the state of the personnel element 222 ispassive, the audio output signal is not transmitted via thecommunication channel. The control system 206 ensures that allcommunication channels associated with elements at which a gaze was notdetected, and which thus remain in a passive state, receive no outputcommunication.

In yet another example, based on the state of the system element 224representing a system 216, the control system 206 controls the outputoperation to determine whether to direct audio input received throughthe audio input device 214 to a dedicated communication channel forvoice commands for the system 216. If the state of the system element224 is listening, the control system 206 may direct the audio input tothe dedicated communication channel for voice commands for the system216 represented by the system 216 and may then process the audio inputreceived from the audio input device 214 using the speech recognitioncontext information designated for the system element 224. Thisprocessing may generate output information that may then be used tocontrol operation of the represented system 216. In this manner, thecontrol system 206 uses the gaze of the user 203 to determine to whichof the information conveyors 212 the audio information of the user 203should be directed.

In still other embodiments, the graphical user interface 210 may presenta real-time image of the environment 200 and the element 219 may be aheadset worn by a person in the real-time image. Controlling the outputoperation at process 408 may include, for example, identifying theinformation conveyor 212 dedicated to at least one of the headset or theperson wearing the headset and directing the audio information to theidentified information conveyor 212.

FIG. 5 is a flowchart illustration of a method 500 for selectivelycontrolling communications over communication channels based on gaze. Inone or more embodiments, the gaze-based communications are to beperformed in the environment 200 of FIG. 2 (e.g. the surgicalenvironment 11 of FIG. 1A). The method 500 is illustrated in FIG. 5 as aset of operations or processes 502 through 518 and is described withcontinuing reference to FIGS. 2-3 . Not all of the illustrated processes502 through 518 may be performed in all embodiments of method 500.Additionally, one or more processes that are not expressly illustratedin FIG. 5 may be included before, after, in between, or as part of theprocesses 502 through 518. In some embodiments, one or more of theprocesses 502 through 518 may be implemented, at least in part, in theform of executable code stored on non-transitory, tangible,machine-readable media that when run by one or more processors (e.g.,the processors of control system) may cause the one or more processorsto perform one or more of the processes.

At process 502, a location of the gaze of the user 203 with respect tothe graphical user interface 210 is identified. In one embodiment, thelocation of the gaze is identified based on the direction of the gaze ofthe user 203. In one or more embodiments, the location of the gaze isidentified as a location in the graphical user interface 210 withrespect to the coordinate system of the graphical user interface 210. Atprocess 504, the element 219 in the graphical user interface 210 that isclosest to the location of the gaze is identified.

At process 506, a determination is made as to whether the distancebetween the identified location of the gaze and the identified element219 is within a distance threshold. In some embodiments, the distancethreshold may be about one to five centimeters. In other embodiments,the distance threshold may be between about two and ten millimeters. Ifthe element 219 in the graphical user interface 210 identified asclosest to the location of the gaze is not within the distancethreshold, the method 500 returns to process 502. Otherwise, at process508, a determination is made as to whether the identified element 219 isassociated with a communication channel (e.g. audio communicationchannel). The communication channel may allow the communication of audioinformation (e.g. audio output) to one or more personnel members 215.

If the identified element 219 does not represent a communicationchannel, at process 510, the audio input device 214 may, optionally, bedeactivated (e.g. set to the passive state), with the method 500 thenreturning to process 502 as described above. Otherwise, at process 512,the audio input device 214 may be activated (e.g. set to the listeningstate) to enable the audio input device 214 to receive audio input. Insome embodiments, the audio input device 214 may be considered activatedor listening even if no communication channels are selected. In thiscase, audio information may be received, recorded, or processed forother purposes that output to a communication channel.

At process 514, the element identified by the user's gaze is set to alistening state. At process 516, an output operation of the controlsystem 206 is controlled based upon the listening state of theidentified element 219 to direct audio information received at the audioinput device 214 to the associated communication channel. For example,the audio information received through the audio input device 214 isdirected to the communication channel that corresponds to the one ormore personnel members represented by the identified element 219. Forexample, when the audio input device 214 is part of a multi-channelintercom system, the topology of the multi-channel intercom system maybe adjusted to selectively direct speech input to the communicationchannel of the multi-channel intercom system that is associated with orrepresented by the identified element 219.

Optionally, at process 518, a visual cue may be presented in thegraphical user interface 210 to indicate that speech input is beingdirected to the communication channel represented by the identifiedelement 219. Optionally, in some embodiments, after the state of theidentified element 219 has been set to the listening state, a visualalert may be generated on a different display device in the environment200. This visual alert may be used to alert the one or more personnelmembers represented by the identified element 219 that speech input willbe directed their way. In one example embodiment, the visual alert maybe the illumination of a light emitting diode on the headset of a nursein the environment 200. In some cases, an audio alert may be generatedthrough an electroacoustic transducer in the environment 200 in additionto or instead of the visual alert. The audio alert may be, for example,a computer-generated verbal cue, a chime, a ring, or some other type ofaudible tone.

FIG. 6 is a flowchart illustration of a method 600 for selectivelycontrolling the operation of systems 216 based on gaze. In one or moreembodiments, the gaze-based communications are to be performed in theenvironment 200 of FIG. 2 (e.g. the surgical environment 11 of FIG. 1A).The method 600 is illustrated in FIG. 6 as a set of operations orprocesses 602 through 614 and is described with continuing reference toFIGS. 2-3 . Not all of the illustrated processes 602 through 614 may beperformed in all embodiments of method 600. Additionally, one or moreprocesses that are not expressly illustrated in FIG. 6 may be includedbefore, after, in between, or as part of the processes 602 through 614.In some embodiments, one or more of the processes 602 through 614 may beimplemented, at least in part, in the form of executable code stored onnon-transitory, tangible, machine-readable media that when run by one ormore processors (e.g., the processors of control system) may cause theone or more processors to perform one or more of the processes.

At process 602, a location of the gaze of the user 203 with respect tothe graphical user interface 210 is identified. In one embodiment, thelocation of the gaze is identified based on the direction of the gaze ofthe user 203. In one or more embodiments, the location of the gaze isidentified as a location in the graphical user interface 210 withrespect to the coordinate system of the graphical user interface 210. Atprocess 604, the element 219 in the graphical user interface 210 that isclosest to the location of the gaze is identified.

At process 606, a determination is made as to whether the distancebetween the identified location of the gaze and the identified element219 is within a distance threshold. In some embodiments, the distancethreshold may be about one to five centimeters. In other embodiments,the distance threshold may be between about two and ten millimeters. Ifthe element 219 in the graphical user interface 210 identified asclosest to the location of the gaze is not within the distancethreshold, the method 600 returns to process 602. Otherwise, at process608, a determination is made as to whether the identified element 219represents a system 216 that is responsive to speech input (i.e. voiceinput).

If the identified element 219 does not represent a system 216 that isresponsive to speech input, then at process 610, the identified element219 is set to a passive state. Setting the identified element 219 to apassive state may include, for example, presenting a visual cue thatindicates the identified element 219 is in the passive state. Forexample, the visual appearance of the identified element 219 may bechanged to indicate that the identified element 219 is in the passivestate. The visual appearance of the element 219 may be changed by, forexample, highlighting the element 219, bolding text associated with theelement 219, displaying a border around the element 219, changing acolor of the element 219, displaying a line across the element 219,changing a size of the element 219, or modifying the appearance of theelement 219 in some other manner. The method 600 then returns to process602 as described above.

With reference again to process 608, if the identified element 219represents a system 216 that is responsive to speech input, then atprocess 612, speech recognition context information designated for thesystem 216 represented by the identified element 219 is selected. Thespeech recognition context information may be obtained from, forexample, without limitation, a database storing speech recognitioncontext information corresponding to various systems. In one exampleembodiment, the speech recognition context information includesinformation about what voice commands are valid for a particular system.

For example, the identified element 219 may be an icon that representsan instrument. In particular, the identified element 219 may be an iconrepresenting an ejection mode for the instrument. Speech recognitioncontext information for this instrument may identify that the word“EJECT” is a valid voice command for the instrument only when the gazeof the user 203 is directed at this particular icon.

As another example embodiment, when the identified element 219represents a medical imaging system, the speech recognition contextinformation for the medical imaging system may identify voice commandsthat are only valid for the medical imaging system. In some cases, thespeech recognition context information for the medical imaging systemmay distinguish between an inactive mode and an active mode for themedical imaging system. For example, when the medical imaging system isin the inactive mode, the speech recognition context information mayidentify “ON,” “TURN ON,” “ENABLE,” and “ACTIVATE” as the only validvoice commands for the medical imaging system. But when the medicalimaging system is in the active mode, the speech recognition contextinformation may identify “OFF,” “TURN OFF,” “DISABLE,” and “DEACTIVATE”as the only valid voice commands for the medical imaging system.

At process 614, the identified element 219 is set to a listening state.Setting the identified element 219 to a listening state may includepresenting a visual cue indicating that the element 219 is in thelistening state. For example, a graphical feature may be displayed overthe identified element 219. In other examples, the visual appearance ofthe element 219 may be changed in any manner that distinguishes thelistening state from the passive state. For example, the visualappearance of the element 219 may be changed by highlighting the element219, bolding text associated with the element 219, displaying a borderaround the element 219, changing a color of the element 219, changing asize of the element 219, or modifying the appearance of the element 219in some other manner. The method 600 may then return to process 602 asdescribed above.

In some embodiments, the process 614 also includes controlling an outputoperation to direct audio information received through the audio inputdevice 214 to the information conveyor 212 associated with theidentified element 219 to thereby control operation of the representedsystem 216. For example, at process 614, activating the element 219 maychange the configuration of the audio input device 214 such that allaudio input is directed to an information conveyor 212, such as acommunication channel, designated for receiving voice commands for therepresented system. Further, in some examples, activating the element219 may configure the audio input device 214 such that no audio input istransmitted on any other information conveyors other than thecommunication channel designated for receiving voice commands for therepresented system 216.

In some embodiments, directing the audio information to the informationconveyor 212 associated with the identified element 219 includesdirectly communicating the audio information to the system 216 over awired or wireless communications link. In other embodiments, directingthe audio information to the information conveyor 212 associated withthe identified element 219 includes sending the audio information via acomputer bus, a wired or wireless communications link, or storage mediafor processing by the control system 206 to generate output informationthat may then be sent to the represented system 216. In still otherembodiments, directing the audio information to the information conveyor212 associated with the identified element 219 includes first processingthe audio information using speech recognition context informationselected based on the identified element 219 to generate outputinformation and then sending the output information to the system 216represented by the identified element 219 over the information conveyor212 associated with the identified element 219.

In some examples, the audio input device 214 may be listening when theelement 219 is set to the listening state. In other examples, multipleinformation conveyors 212 (e.g. communication channels) may be passive(or not listening) and a single communication channel dedicated forreceiving voice commands for the system may be listening.

FIG. 7 is a flowchart illustration of a method 700 for processing voicecommands after an element has been set to a listening state. In one ormore embodiments, the gaze-based communications are to be performed inthe environment 200 of FIG. 2 (e.g. the surgical environment 11 of FIG.1A). The method 700 may be used to process voice commands after theelement 219 is set to the listening state in process 614 of method 600.The method 700 is illustrated in FIG. 7 as a set of operations orprocesses 702 through 708 and is described with continuing reference toFIGS. 2-3 . Not all of the illustrated processes 702 through 708 may beperformed in all embodiments of method 700. Additionally, one or moreprocesses that are not expressly illustrated in FIG. 7 may be includedbefore, after, in between, or as part of the processes 702 through 708.In some embodiments, one or more of the processes 702 through 708 may beimplemented, at least in part, in the form of executable code stored onnon-transitory, tangible, machine-readable media that when run by one ormore processors (e.g., the processors of control system) may cause theone or more processors to perform one or more of the processes.

At process 702, a stream of audio information begins recording. Atprocess 704, a determination is made as to whether a start phrase hasbeen detected. If no start phrase has been detected, the method 700returns to process 702 described above. Otherwise, at process 706, themethod 700 waits until a voice command is detected based on the speechrecognition context information for the system represented by theelement 219. At process 708, a determination is made as to whether thevoice command is valid. If the voice command is valid, then at process710, the voice command is converted to output information (e.g. a systemcommand) for the system represented by the element 219. This systemcommand may be sent to the system itself, a manager, a supervisor, orsome other person.

With reference again to process 708, if the voice command is not valid,a determination is made as to whether the user 203 is still speaking. Ifthe user is not still speaking, the method 700 returns to process 702described above. Otherwise, the method 700 returns to process 706described above. In this manner, once an element 219 representing asystem has been set to a listening state, the control system 206 willrepeatedly attempt to identify a valid voice command from the audiostream. The looped method 700 illustrated in FIG. 7 may be terminated orended once the element 219 is identified as no longer being in thelistening state.

The method 600 described in FIG. 6 and the method 700 described in FIG.7 involve processes that may improve the efficiency with which systems216 are controlled in the environment 200. For example, the user 203 maybe able to use abbreviated voice commands that the control system 206will convert into system commands. By using gaze to initiate the speechrecognition (e.g. voice command recognition) process, the user 203 maynot need to leave, for example, the surgeon's control console 17 of FIG.1A or worry about pressing buttons with his or her hands while he or sheis in the middle of performing or training for a surgical procedure. Byusing gaze-initiated selection of speech recognition context informationdesignated for a particular system 216 prior to giving the voice commandfor a system 216, the processing resources and time need to recognizeand process voice commands may be greatly reduced.

FIG. 8 is a flowchart illustration of a method 800 for conveying audioinformation to a particular information conveyor assigned to aparticular headset using gaze. In one or more embodiments, thegaze-based communications are to be performed in the environment 200 ofFIG. 2 (e.g. the surgical environment 11 of FIG. 1A). The method 800 isillustrated in FIG. 8 as a set of operations or processes 802 through808 and is described with continuing reference to FIGS. 2 . Not all ofthe illustrated processes 802 through 808 may be performed in allembodiments of method 800. Additionally, one or more processes that arenot expressly illustrated in FIG. 8 may be included before, after, inbetween, or as part of the processes 802 through 808. In someembodiments, one or more of the processes 802 through 808 may beimplemented, at least in part, in the form of executable code stored onnon-transitory, tangible, machine-readable media that when run by one ormore processors (e.g., the processors of control system) may cause theone or more processors to perform one or more of the processes.

At process 802, a gaze is detected in which the gaze is of the user 203that is directed at an element 219 in a real-time image of anenvironment 200 presented in the graphical user interface 210 displayedon the display system 204 located in the environment 200. In one or moreembodiments, the real-time image may be a live video of a medicalenvironment (e.g. surgical environment 11 in FIG. 1A). In someembodiments, the real-time image may be generated by an imaging deviceworn by or otherwise attached to the user 203. The imaging device mayhave, for example, a wide field of view. In some cases, the imagingdevice may have a 360-degree field of view. In one or more embodiments,the element 219 is a headset that is worn by a person in the environment200. The person may be a personnel member 215 such as, for example, amember of an operating staff, a clinician, a nurse, or some other typeof person.

In some embodiments, the detection of the gaze being directed at theelement 219 at process 802 may result in a state of the element 219changing to a listening state. For example, the graphical user interface210 may display a visual indicator to indicate that the gaze has beendetected directed at the element 219. The visual indicator may be a textindicator, a graphical indicator displayed over the element 219, or someother type of visual indicator.

At process 804, an information conveyor 212 corresponding to the element219 is identified. Process 804 may be performed in different ways. Insome embodiments, a coded light pattern corresponding to the headset isidentified. The coded light pattern may be presented in the environment200 using a light device. The light device may be, for example, a lightemitting diode (LED) or LED system. The coded light pattern may then bedetected using an imaging device. This imaging device may have, forexample, a high frame-rate to capture the coded light pattern. Theinformation conveyor 212 dedicated to at least one of the headset or theperson wearing the headset may then be identified in response to thedetected coded light pattern.

In other embodiments, a fiducial marker corresponding to the headset inthe real-time image may be detected in response to the gaze beingdirected at the headset. The fiducial marker may be, for example, a tapemarker, an infrared-reflective marker, a fiducial pattern, or some othertype of fiducial marker. The information conveyor 212 dedicated to atleast one of the headset or the person wearing the headset may beidentified based on the detected fiducial marker.

The information conveyor 212 identified at process 804 may be designatedeither for the specific person wearing the headset or a particular roleor responsibility. For example, a particular headset may only be worn byscrub nurses. In this manner, the association between a particularheadset and a particular person or role, and thereby the correspondinginformation conveyor 212, may be predefined.

In other embodiments, identifying the information conveyor 212 atprocess 804 may include verifying that the information conveyor 212should be used for directing audio information to the person wearing theheadset. For example, machine learning or adaptive learning methods maybe used to identify the person wearing a headset. In one embodiment, aheadset may be configured to process speech from a microphone associatedwith the headset to thereby identify the person wearing the headsetbased on speech patterns. The information conveyor 212 may only beidentifiable or selectable at process 804 when the person wearing theheadset has been authorized or validated.

At process 806, audio information is received through the audio inputdevice 214. The audio input device 214 may have been activated either bythe gaze being directed at the element 219, the state of the element 219changing to the listening state, or the identification of theinformation conveyor 212. At process 808, the audio information isdirected to the identified information conveyor 212.

The method 800 may allow the user 203 (e.g. surgeon S) to virtually lookaround the environment 200, observe the personnel members 215 in theenvironment 200, and then selectively communicate with a particularperson by simply gazing at the headset worn by the person. In someembodiments, the headset may use a sensor, switch, or other control todetermine when the headset is worn by a person, when the headset is wornby an authorized person, or both. Accordingly, audio information mayonly be directed to the information conveyor 212 identified as dedicatedto the headset when the headset is actually being worn by a person orwhen the headset is actually being worn by an authorized person.

Thus, the embodiments described above provide a method and apparatus forenabling gaze-based communications. Gaze tracking within the environment(e.g. in conjunction with the surgeon's control console 17 of FIG. 1A)may provide a natural and easy way for the user 203 to selectivelyengage in conversations with individuals or groups of persons over amulti-channel intercom system. Further, gaze tracking may provide anatural and easy way for voice commands to be selectively directedtowards systems in the presence of multiple systems in the environment200.

One or more elements in embodiments of the invention may be implementedin software to execute on a processor of a computer system such ascontrol processing system. When implemented in software, the elements ofthe embodiments of the invention are essentially the code segments toperform the necessary tasks. The program or code segments can be storedin a processor readable storage medium or device that may have beendownloaded by way of a computer data signal embodied in a carrier waveover a transmission medium or a communication link. The processorreadable storage device may include any medium that can storeinformation including an optical medium, semiconductor medium, andmagnetic medium. Processor readable storage device examples include anelectronic circuit; a semiconductor device, a semiconductor memorydevice, a read only memory (ROM), a flash memory, an erasableprogrammable read only memory (EPROM); a floppy diskette, a CD-ROM, anoptical disk, a hard disk, or other storage device. The code segmentsmay be downloaded via computer networks such as the Internet, Intranet,etc.

Note that the processes and displays presented may not inherently berelated to any particular computer or other apparatus. Variousgeneral-purpose systems may be used with programs in accordance with theteachings herein, or it may prove convenient to construct a morespecialized apparatus to perform the operations described. The requiredstructure for a variety of these systems will appear as elements in theclaims. In addition, the embodiments of the invention are not describedwith reference to any particular programming language. It will beappreciated that a variety of programming languages may be used toimplement the teachings of the invention as described herein.

While certain exemplary embodiments of the invention have been describedand shown in the accompanying drawings, it is to be understood that suchembodiments are merely illustrative of and not restrictive on the broadinvention, and that the embodiments of the invention not be limited tothe specific constructions and arrangements shown and described, sincevarious other modifications may occur to those ordinarily skilled in theart.

What is claimed is:
 1. A method comprising: displaying an image of anenvironment on a graphical user interface, the environment including aplurality of personnel elements visible in the image; detecting a gazeof a user that is directed at an image of a first personnel element ofthe plurality of personnel elements in the environment visible in theimage of the environment, the first personnel element corresponding to afirst information conveyor of a plurality of information conveyors;changing a state of the first information conveyor corresponding to thefirst personnel element from a passive state to a listening state inresponse to detecting that the gaze is directed at the image of thefirst personnel element, wherein the first information conveyor includesa first audio output device of a plurality of audio output devices inthe environment; receiving audio information through an audio inputdevice; and when the state of the first information conveyor is changedto the listening state, controlling an output operation, wherein theoutput operation includes directing the received audio information as anaudio output through the first audio output device in the environment.2. The method of claim 1, wherein changing the state of the firstinformation conveyor further comprises: presenting a visual cue in thegraphical user interface indicating that the first information conveyoris in the listening state.
 3. The method of claim 2, wherein presentingthe visual cue comprises: displaying a graphical feature in associationwith the image of the first personnel element in the graphical userinterface while the first personnel element is in the listening state.4. The method of claim 2, wherein presenting the visual cue comprises:changing an appearance of the image of the first personnel element inthe graphical user interface while the first information conveyor is inthe listening state by at least one of highlighting the first personnelelement, bolding text associated with the first personnel element,displaying a border around the first personnel element, or changing acolor of the first personnel element.
 5. The method of claim 1, whereindirecting the received audio information includes determining a trackedlocation of the first personnel element within the environment andselectively directing the received audio information through the firstaudio output device and none of the other of the plurality of audiooutput devices.
 6. The method of claim 1, wherein the image of theenvironment is a real-time image of the environment and the firstpersonnel element in the real-time image of the environment is a person.7. The method of claim 1, wherein the image of the environment is areal-time image of the environment and the first personnel element inthe real-time image of the environment is a device worn by or associatedwith a personnel member.
 8. The method of claim 1, wherein receiving theaudio information comprises: receiving at least one of a voice command,audio instructions, an audio report, or audio commentary related to asurgical procedure.
 9. The method of claim 1, wherein receiving theaudio information comprises: recording a surgical case note as dictatedby the user.
 10. The method of claim 1, further comprising: generating avisual alert on a display device in the environment in response to thestate of the first information conveyor being changed.
 11. The method ofclaim 1, further comprising: generating an audio alert through anelectroacoustic transducer in the environment in response to the stateof the first information conveyor being changed.
 12. The method of claim1, wherein the image of the environment is a real-time image of theenvironment and the first personnel element is a headset worn by aperson in the real-time image of the environment.
 13. The method ofclaim 12, wherein controlling the output operation comprises:identifying the first information conveyor dedicated to at least one ofthe headset or the person wearing the headset; and directing the audioinformation to the identified first information conveyor.
 14. The methodof claim 13, wherein identifying the first information conveyorcomprises: identifying a coded light pattern corresponding to theheadset; presenting the coded light pattern in the environment using alight device; detecting the coded light pattern using an imaging device;and identifying the first information conveyor dedicated to the at leastone of the headset or the person wearing the headset in response to thedetected coded light pattern.
 15. The method of claim 13, whereinidentifying the first information conveyor comprises: detecting afiducial marker corresponding to the headset in the image of theenvironment in response to the gaze being directed at the headset; andidentifying the first information conveyor dedicated to the at least oneof the headset or the person wearing the headset based on the fiducialmarker.
 16. A method for selectively communicating audio informationusing gaze, the method comprising: displaying an image of an environmenton a graphical user interface, the environment including a plurality ofpersonnel elements and a plurality of audio output devices; detecting agaze of a user that is directed at an image of a first personnel elementof the plurality of personnel elements visible in the image of theenvironment, wherein the first personnel element is associated with atleast one communication channel; changing a state of a communicationchannel associated with the first personnel element in the environmentto a listening state in response to detecting that the gaze is directedat the image of the first personnel element in the environment;presenting a visual cue in the graphical user interface indicating thatthe communication channel is now in the listening state; receiving audioinformation through an audio input device; directing the audioinformation received through the audio input device to the communicationchannel associated with the first personnel element in the environmentwhile the communication channel is in the listening state; andtransmitting, via the communication channel, an audio output signalincluding the received audio information into the environment, through afirst audio output device of the plurality of audio output devices, whenthe communication channel is changed to the listening state.
 17. Anapparatus comprising: a display system configured to display an image ofan environment that includes a plurality of personnel elements visiblein the image and a plurality of audio output devices; a gaze trackingsystem configured to detect a gaze of a user that is directed at a firstpersonnel element of the plurality of personnel elements visible in theimage of the environment; an audio input device configured to receiveaudio information; and a processor configured to change an informationconveyor corresponding to the first personnel element to a listeningstate in response to detecting that the gaze is directed at the firstpersonnel element in the image of the environment and to control anoutput operation, wherein the information conveyor includes a firstaudio output device of the plurality of audio output devices in theenvironment and wherein, in the listening state, the output operationincludes directing the received audio information as an audio outputthrough the first audio output device in the environment.
 18. Theapparatus of claim 17, wherein the image of the environment is areal-time image of the environment and the first personnel element is aperson in the environment.
 19. The apparatus of claim 17, wherein theimage of the environment is a real-time image of the environment and thefirst personnel element is a device worn by or associated with apersonnel member in the environment.
 20. The apparatus of claim 17,wherein the processor is further configured to present a visual cue onthe display system indicating that the information conveyorcorresponding to the first personnel element is in the listening state.21. A method comprising: displaying a real-time image of an environmenton a graphical user interface, wherein the environment includes aplurality of personnel elements and a plurality of audio output devices;detecting a gaze of a user that is directed at a real-time image of afirst personnel element of the plurality of personnel elements in thereal-time image of the environment; identifying an information conveyorcorresponding to the first personnel element in the environment, whereinthe information conveyor includes a first audio output device of theplurality of audio output devices in the environment; changing a stateof the real-time image of the first personnel element and theinformation conveyor corresponding to the first personnel element to alistening state in response to detecting that the gaze is directed atthe first personnel element; receiving audio information through anaudio input device; and when in the listening state, directing thereceived audio information as audio output through the first audiooutput device in the environment.
 22. The method of claim 21, whereinthe first personnel element is a headset worn by a person in thereal-time image and wherein identifying the information conveyorcomprises: identifying a coded light pattern corresponding to theheadset; presenting the coded light pattern in the environment using alight device; detecting the coded light pattern using an imaging device;and identifying the information conveyor dedicated to at least one ofthe headset or the person wearing the headset in response to thedetected coded light pattern.
 23. The method of claim 21, wherein thefirst personnel element is a headset worn by a person in the real-timeimage and wherein identifying the information conveyor comprises:detecting a fiducial marker corresponding to the headset in thereal-time image in response to the gaze being directed at the headset;and identifying the information conveyor dedicated to at least one ofthe headset or the person wearing the headset based on the detectedfiducial marker.
 24. The method of claim 1, wherein the environment is amedical environment external to a patient anatomy.